This inspection took place on the 1 August 2018 and was unannounced. At the previous inspection in February 2017 the service was rated as Good overall. The Responsive question was rated as Requires Improvement. We found one breach of regulations because accurate and up to date records were not maintained in relation to people’s care and treatment. During this inspection we found this issue had been addressed.

Bennetts Castle Care Centre is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Bennetts Castle Care Centre is a purpose-built care home which provides nursing care to older people, many of whom live with dementia. It is registered to provide care to a maximum of 64 people, 60 people were using the service at the time of our inspection.

The service has not had a registered manager in place since February 2018. There was a manager in place and we were told they intended to apply for registration with the Care Quality Commission in the near future. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We have made one recommendation in this report, that records are maintained of checks on the emergency lighting systems at the service.

There were enough staff working at the service to meet people’s needs and robust staff recruitment procedures were in place. Appropriate safeguarding procedures were in place. Risk assessments provided information about how to support people in a safe manner. Procedures were in place to reduce the risk of the spread of infection. Medicines were managed safely.

People’s needs were assessed before they started using the service to determine if those needs could be met. Staff received on-going training to support them in their role. People were able to make choices for themselves and the service operated within the principles of the Mental Capacity Act 2005. People told us they enjoyed the food. People were supported to access relevant health care professionals.

People told us they were treated with respect and that staff were caring. Staff had a good understanding of how to promote people’s privacy, independence and dignity.

Care plans were in place which set out how to meet people’s individual needs. Care plans were subject to regular review. People were supported to engage in various activities. The service had a complaints procedure in place and people knew how to make a complaint.

Staff and people spoke positively about the senior staff at the service. Quality assurance and monitoring systems were in place which included seeking the views of people who used the service.

This inspection took place on the 1 and 2 February 2017 and was unannounced. At the previous inspection of this service in October 2014 we found one breach of regulations. This was because the service did not have effective systems in place for the safe administration of medicines. During this inspection we found this issue had been addressed.

Bennetts Castle Care Centre is registered with the Care Quality Commission to provide accommodation and support with nursing and personal care for up to 64 adults. At the time of our inspection 63 adults lived at the service. The service specialised in providing care to people living with dementia and nursing care needs.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

During this inspection we found one breach of regulations. This was because record keeping was not always completed appropriately. You can see what action we have asked the provider to take at the end of this report.

There were enough staff working at the service to meet people’s needs and robust staff recruitment procedures were in place. Appropriate safeguarding procedures were in place and people told us they felt safe using the service. Risk assessments provided information about how to support people in a safe manner. Medicines were managed safely.

Staff undertook an induction training programme on commencing work at the service and received on-going training after that. People were able to make choices for themselves where they had the capacity to do so and the service operated within the Mental Capacity Act 2005. People told us they enjoyed the food. People were supported to access relevant health care professionals.

People told us they were treated with respect and that staff were caring. Staff had a good understanding of how to promote people’s privacy, independence and dignity.

People’s needs were assessed before they began using the service. Care plans were in place which set out how to meet people’s individual needs. People were supported to engage in various activities. The service had a complaints procedure in place and people knew how to make a complaint.

Staff and people spoke positively about the registered manager. Systems were in place to seek the views of people on the running of the service.

This inspection took place on 1 October 2014 and was unannounced. At the last inspection in August 2013 the service was found to be meeting the regulations we looked at. At this inspection we found that medicines were not always safely stored and administered. You can see what action we told the provider to take at the back of the full version of the report.

Bennetts Castle Care Centre is registered with the Care Quality Commission to provide accommodation and support with nursing and personal care for up to 64 adults. At the time of our inspection 62 adults lived at the service. The service specialised in providing care to people with dementia and nursing care needs. The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The service met the regulations we inspected against at their last inspection which took place on 7 August 2013.

People told us they felt safe living at the service. We found staff had a good understanding of their responsibility with regard to safeguarding adults. The service sought to minimise the risks people faced, for example by assessing risks to individuals and implementing strategies to minimise those risks. There were enough staff working at the service to meet people’s needs. We found some instances where medicines were not stored and administered correctly.

Staff undertook training and received one to one supervision to help support them to provide effective care. Not all staff had an appraisal of their performance but this was an area the service had identified as in need of improvement. The registered manager and staff had a good understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). People told us they liked the food provided and we saw people were able to choose what they ate and drank. People had access to health care professionals as appropriate.

We found that people were treated in a caring and sensitive manner. People told us staff treated them with respect. Staff were aware of how to promote people’s choice, privacy and independence.

People’s needs were assessed and met in a personalised manner. We found that care plans were in place which included information about how to meet a person’s individual and assessed needs. The commissioning team of the relevant local authority told us they did not have any concerns about the care and support provided at the service. The service had a complaints procedure and we found that complaints were investigated and where possible resolved to the satisfaction of the complainant.

The service had a registered manager and a management structure with clear lines of accountability. Staff told us the service had an open and inclusive atmosphere and senior staff were approachable and accessible. The service had various quality assurance and monitoring mechanisms in place. These included surveys, audits and meetings with various stakeholders.

People expressed their views and were involved in making decisions about their care and treatment. People told us they were treated with dignity and respect and were able to make choices about their care and treatment. Comments included "I tell them what I want to eat" and "I chose to wear this blouse, it's one of my favourites."

People told us they were they were satisfied with the care and treatment they received. Comments included "the staff are all okay, pretty good" and "they're lovely here." We saw that care plans were in place for each person. We saw that people had access to healthcare professionals. People told us they felt safe and would tell staff if they had any concerns. Comments included "I have no concerns" and "I've got no problems here."

People told us that they were satisfied with the staff. Comments included "everybody's so nice" and "they're a lovely lot." Appropriate checks were undertaken before staff began to work for the service. Staff files contained the necessary documentation. People said the staff and management of service were very open and approachable. One person said "If I had any concerns I'm confident they would deal with it." Staff told us they were not asked for their views about how the service operated.

People told us that the service was meeting their care needs and that the service supported them with social and leisure activities. One person said “we all went out to the pub last time.” We found that care plans and risk assessments were in place for people. People had access to health care professionals, including community nurses and GP's. We found that people were provided with sufficient amounts to eat and drink, and that they had choice over what they ate. One person said “if you don’t like the food you can say and they’ll give you something else.”

People told us they felt safe at the service. When asked if they felt safe, one person replied "yeah, oh yeah safe. I would not stay here otherwise." However, we found that many staff had not undertaken any training in safeguarding vulnerable adults, and some of the staff we spoke with had only a limited understanding of their roles and responsibilities with regard to safeguarding vulnerable adults.

We found that medications were stored securely, and that staff had regular supervision and training.

People told us what it was like to live at the home and described how they were treated by staff. They were involved in making choices about their care. People were happy with the care they received and said that the home was improving. One relative said “the home did go downhill but it is on the way up again. My father is well looked after and safe.” Another said “the home is getting back on track. My father is looked after okay and is safe here.” One person smiled broadly and said yes when asked if the staff were nice. Another told us “staff are good and know if you are not feeling well.”

People were treated with respect and their care and welfare needs were being met. Systems were in place to safeguard people from abuse. Staff had received additional safeguarding training and their knowledge and awareness of safeguarding had increased. The provider and management team monitored the quality of the service provided to ensure that it was safe and met people’s needs.

We spoke to people who use the service and their relatives about the quality of care that was provided at Bennetts Castle. They told us that they happy with the care provided and satisfied with the quality of the service. Comments from people who use the service included: “The girls are nice and look after us well. The carers are kind. Not everyone here knows what day it is but the staff are really kind and patient with them. You just call out if you need staff and they come. You don’t have to have the food if you don’t like it. You don’t have to do things if you don’t want to.”

Relatives said, “We are happy with the care and feel that our relatives are well looked after.” “My mother likes it here and is so well looked after. Staff are kind and helpful and we have no complaints. Mum was in hospital for a while and I was concerned as to how she would settle back in. The girls made a fuss of her and settled her in and she was fine. This really reassured me about how they looked after her.”

A reviewing officer for Barking and Dagenham told us that during the course of recent reviews people who use the service and their relatives had indicated that they were happy with the care that had been provided and had not expressed any concerns for their safety.

However, the local authority alerted us to a safeguarding issue that had arisen at the service following which we attended a meeting held by Barking & Dagenham in line with Safeguarding Vulnerable Adults procedures. The evidence available at that time indicated that the service was aware of a risk of harm to a person using the service. In spite of this, it was not evident that any appropriate safeguarding measures had been in place for the person's protection. Due to the seriousness of the situation and the concerns about the service and people's safety, an investigation is being carried out by the Barking and Dagenham safeguarding team. In addition they have placed a temporary suspension on new placements to the service.

The people that we spoke to were happy with the care that they received. People said, “the girls are always here to help,” and “the girls are lovely, no problems.” One person said, “the staff are helpful and once when I buzzed for help they came straightaway.”

When asked about medication one person told us that she usually had her tablets around breakfast time and that staff never woke her up for her tablets. Another told us that staff did not wake her up for her tablets but she sometimes did have her tablets in bed and she sat up to take them.

We were told that meals were pretty good and included fresh vegetables and that there was always a jug of drink. One person told as that "one of the girls" got some fruit for her and that she could “pick a sandwich” as that was all she wanted at suppertime.

People told us that they could make choices about “all sorts of things.” One person told us that she chose to spend time in her room. She also told us that she'd been in hospital and had been worried that she wouldn't be able to come back to Bennetts Castle.

One of the people we spoke to told us that some of the people at Bennetts Castle had dementia and that she had seen that the staff were kind to them.

Staff spoken to were also positive about the care that people received. One person said, “people get good care and I don't have any concerns.” Another said, “there are a lot of good things about the service, good meals, good carers and lots of choice. I don't have any concerns.”

A commissioning and quality assurance officer from the local authority visited the service twice after the concerns had been raised. They said, “everything was fine and I am satisfied that the residents are well looked after. There will be no further action from me.”